Basic Information
| Provider Information | |||||||||
| NPI: | 1801451984 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARP | ||||||||
| FirstName: | ANTHONY | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2944 CHEROKEE RD | ||||||||
| Address2: | |||||||||
| City: | SAINT CLOUD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347727430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212817588 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10000 W COLONIAL DR | ||||||||
| Address2: | |||||||||
| City: | OCOEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347613400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3218413467 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2019 | ||||||||
| LastUpdateDate: | 02/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN11002286 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.